NPI | 1518101674 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 21124) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP 9405374) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NN08407200) | |
Enumeration Date | 2009-04-20 |
Last Update Date | 2022-07-21 |