NPI | 1962170191 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 305138) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN210520) |
208000000X Pediatrics (Licence: AZ 305138) | |
Enumeration Date | 2021-09-02 |
Last Update Date | 2025-03-17 |