NPI | 1740902048 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11020582) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11020582) |
Enumeration Date | 2022-09-13 |
Last Update Date | 2023-11-15 |