NPI | 1194378539 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 8747) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CT 124342) |
Enumeration Date | 2019-07-23 |
Last Update Date | 2022-04-14 |