NPI | 1215455605 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 222585) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024175133) |
Enumeration Date | 2017-09-06 |
Last Update Date | 2019-07-26 |