NPI | 1386274918 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: ND R48816) |
Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MN 6950) |
Enumeration Date | 2020-01-23 |
Last Update Date | 2020-03-02 |