NPI | 1982372413 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11030760) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-181240) |
Enumeration Date | 2021-08-31 |
Last Update Date | 2024-03-25 |