NPI | 1548746365 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5010693) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NC 5010693) |
Enumeration Date | 2018-07-15 |
Last Update Date | 2020-10-28 |