NPI | 1043863608 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 8337) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 144665) |
Enumeration Date | 2019-07-22 |
Last Update Date | 2019-07-22 |