NPI | 1760988539 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP018713) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LJ-0000337) |
Enumeration Date | 2018-04-02 |
Last Update Date | 2018-12-18 |