NPI | 1992204416 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP09725) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP09725) |
Enumeration Date | 2018-02-10 |
Last Update Date | 2022-05-26 |