NPI | 1538651419 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11001734) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 24253) |
Enumeration Date | 2018-06-05 |
Last Update Date | 2019-03-06 |