NPI | 1457923963 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.0030143) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 92838) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP024604) | |
Enumeration Date | 2021-07-14 |
Last Update Date | 2023-06-15 |