NPI | 1225388598 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95005399) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2274852) |
Enumeration Date | 2012-09-14 |
Last Update Date | 2022-07-21 |