NPI | 1568654903 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010373) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 250343) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209-004496) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 286171) | |
Enumeration Date | 2007-08-09 |
Last Update Date | 2021-03-16 |