NPI | 1013253483 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 5375870-081) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2012040795) |
Enumeration Date | 2012-12-12 |
Last Update Date | 2012-12-12 |