NPI | 1194303347 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.023347) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 209.023347) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1014952) | |
Enumeration Date | 2021-03-30 |
Last Update Date | 2022-06-27 |