NPI | 1033356555 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN219545) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 381916) |
Enumeration Date | 2009-01-21 |
Last Update Date | 2013-07-24 |