| NPI | 1992100291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: TN APN22677) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: GA RN242574) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2019-01-18 |