NPI | 1235173030 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 200280) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP1792202) |
Enumeration Date | 2006-06-15 |
Last Update Date | 2014-12-08 |