NPI | 1750914065 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-173715) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-173715) |
Enumeration Date | 2020-02-14 |
Last Update Date | 2023-06-11 |