NPI | 1083064364 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: TN 21225) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 21225) |
363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: FL APRN11018760) | |
Enumeration Date | 2016-06-16 |
Last Update Date | 2024-06-14 |