NPI | 1649851734 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-185641) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-185641) |
163W00000X Registered Nurse (Licence: OH RN.423570) | |
Enumeration Date | 2021-04-20 |
Last Update Date | 2023-01-09 |