NPI | 1194375527 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 267823) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: TX 892138) |
Enumeration Date | 2019-09-17 |
Last Update Date | 2021-12-23 |