NPI | 1013552256 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5017184) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 287779) |
Enumeration Date | 2019-11-12 |
Last Update Date | 2022-12-29 |