NPI | 1730721309 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11002399) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL aprn11002399) |
Enumeration Date | 2019-10-15 |
Last Update Date | 2021-06-21 |