NPI | 1043316417 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN232945) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC APN17983RX) |
Enumeration Date | 2006-09-15 |
Last Update Date | 2017-01-09 |