NPI | 1154566636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 066587-23) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 4828) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN285467) | |
Enumeration Date | 2008-12-11 |
Last Update Date | 2022-09-09 |