NPI | 1164882544 |
---|---|
Former Name | EBONY N BROWN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2016001982) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 77121) |
Enumeration Date | 2016-02-29 |
Last Update Date | 2018-11-27 |