NPI | 1154686517 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1156014) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 16477) |
Enumeration Date | 2012-07-11 |
Last Update Date | 2017-04-20 |