NPI | 1972004604 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11005966) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP136767) |
Enumeration Date | 2018-02-27 |
Last Update Date | 2020-02-11 |