NPI | 1710435128 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN9309748) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP131675) |
363LF0000X Nurse Practitioner, Family (Licence: FL 9309748) | |
Enumeration Date | 2016-09-14 |
Last Update Date | 2021-12-09 |