NPI | 1245909969 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 11371-33) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 11317) |
Enumeration Date | 2021-09-07 |
Last Update Date | 2025-06-30 |