| NPI | 1982103198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS 902560) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 210241) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 20163711) | |
| Enumeration Date | 2018-02-03 |
| Last Update Date | 2019-06-10 |