NPI | 1366410284 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 266254) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 266254) |
Enumeration Date | 2006-03-08 |
Last Update Date | 2007-07-08 |