NPI | 1376216648 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP002085) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SD CP002085) |
Enumeration Date | 2021-07-31 |
Last Update Date | 2021-09-11 |