NPI | 1124790449 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024187431) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5015161) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: NC BARN-BK5PT) | |
Enumeration Date | 2021-10-05 |
Last Update Date | 2023-08-28 |