NPI | 1043639255 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 274213) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.011209) |
Enumeration Date | 2014-04-15 |
Last Update Date | 2022-07-20 |