NPI | 1316542442 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-174930) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-174930) |
Enumeration Date | 2020-12-04 |
Last Update Date | 2023-01-23 |