NPI | 1376798603 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-082462) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: AL 1-082462) |
Enumeration Date | 2008-12-01 |
Last Update Date | 2020-07-10 |