NPI | 1245680388 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC F0616124) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5008778) |
Enumeration Date | 2016-06-20 |
Last Update Date | 2020-05-19 |