NPI | 1205380185 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20408) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 54-20408) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 20408) | |
Enumeration Date | 2016-08-09 |
Last Update Date | 2023-05-24 |