NPI | 1073691069 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 698685) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 698685) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2008-07-28 |