NPI | 1831641562 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 2691202) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: FL ARNP2691202) |
Enumeration Date | 2016-10-28 |
Last Update Date | 2017-09-25 |