NPI | 1972564102 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN139381) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 172752) |
Enumeration Date | 2006-03-29 |
Last Update Date | 2021-03-09 |