NPI | 1104979822 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-062777) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-062777) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2023-06-30 |