NPI | 1275073652 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP028884) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: NJ H96670966160954) |
Enumeration Date | 2017-03-03 |
Last Update Date | 2023-12-07 |