NPI | 1336730597 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11012982) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 2020092643) |
Enumeration Date | 2021-01-31 |
Last Update Date | 2025-07-14 |