NPI | 1457775819 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2022037507) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN150105) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2021019303) | |
Enumeration Date | 2014-02-05 |
Last Update Date | 2024-08-01 |