NPI | 1124470299 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 7019) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 702194) |
Enumeration Date | 2016-07-12 |
Last Update Date | 2022-03-09 |