NPI | 1114269073 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.009586) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.355428) |
Enumeration Date | 2013-03-19 |
Last Update Date | 2013-03-19 |