NPI | 1255569125 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R 160179) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R160179) |
Enumeration Date | 2009-06-30 |
Last Update Date | 2009-11-20 |