NPI | 1073754420 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM R51848) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM R51848) |
Enumeration Date | 2009-03-16 |
Last Update Date | 2013-09-13 |