NPI | 1326794421 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP021784) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA SP021784) |
363A00000X Physician Assistant (Licence: PA SP021784) | |
363L00000X Nurse Practitioner (Licence: PA SP021784) | |
Enumeration Date | 2022-02-27 |
Last Update Date | 2022-03-09 |