NPI | 1053887976 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F383352-01) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 24968) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 24968) | |
Enumeration Date | 2018-10-18 |
Last Update Date | 2022-09-07 |