NPI | 1154000354 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5021235) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024187557) |
Enumeration Date | 2023-07-14 |
Last Update Date | 2025-07-11 |