NPI | 1295188043 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.015914) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 704160) |
Enumeration Date | 2016-07-18 |
Last Update Date | 2021-12-28 |