NPI | 1205081783 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ARNP9219689) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 10/18/2008 04/30/20) |
Enumeration Date | 2008-11-25 |
Last Update Date | 2010-12-09 |