NPI | 1083343453 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C164462) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA C164462) |
Enumeration Date | 2022-06-09 |
Last Update Date | 2023-08-03 |