NPI | 1619644861 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: IL 209-023848) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.023848) |
Enumeration Date | 2021-08-25 |
Last Update Date | 2024-10-03 |