NPI | 1518396985 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024172978) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD AC001267) |
Enumeration Date | 2013-11-06 |
Last Update Date | 2021-10-06 |