NPI | 1003021080 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NC 5004154) |
Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: AZ RN048722) |
363LP0200X Nurse Practitioner Pediatrics (Licence: AZ AP1290) | |
Enumeration Date | 2007-05-11 |
Last Update Date | 2022-12-20 |