NPI | 1316464225 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN9355487) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9355487) |
363L00000X Nurse Practitioner (Licence: TX 1074372) | |
Enumeration Date | 2017-08-23 |
Last Update Date | 2024-12-10 |