NPI | 1952622334 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN9206610) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9206610) |
Enumeration Date | 2010-06-19 |
Last Update Date | 2018-10-29 |