NPI | 1063421808 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9429523) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NN06537700) |
Enumeration Date | 2006-08-07 |
Last Update Date | 2017-10-13 |