NPI | 1124574710 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MD R174386) |
Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP016535) |
Enumeration Date | 2016-09-01 |
Last Update Date | 2023-09-01 |