NPI | 1932232121 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004784) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: KS 14-55117-032) |
Enumeration Date | 2007-03-14 |
Last Update Date | 2021-02-19 |