NPI | 1811418981 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 9523223-4405) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 714498-1) |
163W00000X Registered Nurse (Licence: UT 9523223-3102) | |
Enumeration Date | 2017-06-29 |
Last Update Date | 2024-03-04 |