NPI | 1720395700 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11005672) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: RI NPP37580) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2262105) | |
Enumeration Date | 2010-09-11 |
Last Update Date | 2022-12-08 |