| NPI | 1942504634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 27606) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA SP010909) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN247655) | |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2022-03-16 |