NPI | 1649520081 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NC 5019331) |
Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX 662712) |
Enumeration Date | 2012-09-13 |
Last Update Date | 2024-03-26 |