NPI | 1669141669 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 35648) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: GA RN259102) |
Enumeration Date | 2021-09-13 |
Last Update Date | 2024-06-18 |