NPI | 1821554148 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 28529) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 216480) |
Enumeration Date | 2019-02-11 |
Last Update Date | 2020-11-13 |