NPI | 1104296409 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95003570) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209012443) |
Enumeration Date | 2015-09-29 |
Last Update Date | 2024-11-13 |