NPI | 1679137467 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN283116) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11000487) |
Enumeration Date | 2019-04-26 |
Last Update Date | 2019-09-27 |