NPI | 1770557423 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 28797) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL ARNP9206478) |
363L00000X Nurse Practitioner (Licence: FL ARNP9206478) | |
Enumeration Date | 2006-02-16 |
Last Update Date | 2021-04-07 |