NPI | 1649802083 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11032545) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 945476) |
Enumeration Date | 2020-02-04 |
Last Update Date | 2024-05-23 |