NPI | 1700163037 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 16175) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 178685) |
Enumeration Date | 2011-11-15 |
Last Update Date | 2022-03-30 |