NPI | 1104191402 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: IN 71003910A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28157102A) |
Enumeration Date | 2012-03-20 |
Last Update Date | 2020-12-15 |