NPI | 1942972625 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP022644) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP022644) |
363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP022644) | |
Enumeration Date | 2021-10-01 |
Last Update Date | 2025-08-20 |