NPI | 1053043034 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95021790) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2347915) |
Enumeration Date | 2022-06-28 |
Last Update Date | 2022-08-21 |