NPI | 1124573811 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP9438846) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 21604) |
Enumeration Date | 2016-08-23 |
Last Update Date | 2018-03-17 |