NPI | 1053816272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11004232) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11004232) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004232) | |
Enumeration Date | 2018-03-28 |
Last Update Date | 2023-11-15 |