NPI | 1679508535 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN742982) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: FL ARNP742982) |
Enumeration Date | 2006-07-11 |
Last Update Date | 2020-11-16 |