NPI | 1912483595 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN9266804) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9266804) |
Enumeration Date | 2018-07-17 |
Last Update Date | 2019-06-27 |