NPI | 1821264565 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL APRN9473715) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9473715) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 130810) | |
Enumeration Date | 2008-05-02 |
Last Update Date | 2019-04-26 |