NPI | 1376283804 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5016119) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC MCGE-P84I8) |
Enumeration Date | 2022-03-31 |
Last Update Date | 2024-07-30 |