NPI | 1184294605 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 202017962) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 202017962) |
Enumeration Date | 2021-06-28 |
Last Update Date | 2023-01-10 |