NPI | 1124188404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013211) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA RN2257867) |
Enumeration Date | 2006-12-09 |
Last Update Date | 2013-10-08 |