| NPI | 1982707501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 3394) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN APN0000011110) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2014-10-08 |