NPI | 1063161230 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11018397) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11018397) |
Enumeration Date | 2022-03-23 |
Last Update Date | 2025-10-01 |