NPI | 1235699638 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA 221734) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN145397) |
Enumeration Date | 2019-03-21 |
Last Update Date | 2021-08-23 |