NPI | 1295249050 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 7780) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 124184) |
Enumeration Date | 2017-11-30 |
Last Update Date | 2018-10-15 |