NPI | 1972012581 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 35919) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95005878) |
Enumeration Date | 2017-09-26 |
Last Update Date | 2024-04-17 |