NPI | 1578183067 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 30846) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 216365) |
Enumeration Date | 2020-04-24 |
Last Update Date | 2021-12-30 |