NPI | 1174105878 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11010656) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11010656) |
163W00000X Registered Nurse (Licence: CA 796589) | |
163W00000X Registered Nurse (Licence: FL 3275812) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95010132) | |
Enumeration Date | 2021-04-22 |
Last Update Date | 2023-01-12 |