NPI | 1467058529 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: AL 1-169361) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-169361) |
Enumeration Date | 2020-12-04 |
Last Update Date | 2022-11-30 |