NPI | 1336806876 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV 108740) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP031560) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MD AC007193) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: SC APN.25464) | |
Enumeration Date | 2021-11-18 |
Last Update Date | 2024-12-07 |