NPI | 1134206287 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 003428) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2013013677) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: NE 110350) | |
Enumeration Date | 2006-11-01 |
Last Update Date | 2013-07-25 |