NPI | 1639589146 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R197298) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R197298) |
Enumeration Date | 2014-05-06 |
Last Update Date | 2018-04-17 |