NPI | 1376051094 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP9248488) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9248488) |
363LF0000X Nurse Practitioner, Family (Licence: FL 9248488) | |
Enumeration Date | 2018-01-16 |
Last Update Date | 2020-07-30 |