NPI | 1811307234 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA 197567) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN197567) |
Enumeration Date | 2014-05-07 |
Last Update Date | 2021-02-03 |