NPI | 1114494002 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: AR 227343) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95020554) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2303260) | |
Enumeration Date | 2018-10-29 |
Last Update Date | 2025-09-19 |