NPI | 1578932794 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 19702) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 155654) |
Enumeration Date | 2015-09-17 |
Last Update Date | 2020-10-29 |