NPI | 1710629704 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: WY 53158) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 41646) |
Enumeration Date | 2022-04-10 |
Last Update Date | 2023-10-13 |