NPI | 1205109964 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: WI 6310-33) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 153325-30) |
Enumeration Date | 2012-02-10 |
Last Update Date | 2015-05-05 |