NPI | 1275890485 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2297798) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH COA.15211-NP) |
Enumeration Date | 2012-04-12 |
Last Update Date | 2014-12-18 |