NPI | 1417476839 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5015022) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN209473) |
Enumeration Date | 2017-09-18 |
Last Update Date | 2022-08-22 |