NPI | 1780062299 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A122492) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012668) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: IA A122492) | |
Enumeration Date | 2015-05-16 |
Last Update Date | 2018-09-13 |