NPI | 1528626397 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C154279) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA C-154279) |
Enumeration Date | 2019-06-05 |
Last Update Date | 2023-11-21 |