NPI | 1194594036 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5019933) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-12-20 |
Last Update Date | 2024-05-22 |