NPI | 1790363737 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: LA 218978) |
Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: GA 207836) |
Enumeration Date | 2021-03-31 |
Last Update Date | 2023-08-29 |