NPI | 1104455633 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN301093) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: IL 041422092) |
Enumeration Date | 2020-04-06 |
Last Update Date | 2021-05-20 |