NPI | 1225614209 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024185704) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001303524) |
163W00000X Registered Nurse (Licence: DC RN1040218) | |
Enumeration Date | 2021-03-22 |
Last Update Date | 2022-12-02 |