NPI | 1922525153 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 9283274) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9283274) |
Enumeration Date | 2017-08-28 |
Last Update Date | 2017-08-28 |