NPI | 1245304534 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209008728) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 20061649) |
Enumeration Date | 2006-11-20 |
Last Update Date | 2011-07-07 |