NPI | 1053030650 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11021493) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: FL 9398587) |
Enumeration Date | 2022-08-25 |
Last Update Date | 2024-10-28 |