NPI | 1629474291 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024186565) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95001575) |
Enumeration Date | 2014-11-10 |
Last Update Date | 2024-07-15 |