NPI | 1053000539 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: AL 1-190402) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-190402) |
Enumeration Date | 2023-05-02 |
Last Update Date | 2025-02-18 |