NPI | 1114080405 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN052324) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN052324) |
Enumeration Date | 2006-12-18 |
Last Update Date | 2021-07-19 |