NPI | 1760093298 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C177438) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-81038-122) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2022010794) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP022159) | |
Enumeration Date | 2020-08-10 |
Last Update Date | 2024-05-23 |