NPI | 1629048418 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 001227) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL arn9433697) |
Enumeration Date | 2006-01-24 |
Last Update Date | 2024-05-10 |