NPI | 1386720175 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2269575) |
Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: NC 5003911) |
363L00000X Nurse Practitioner (Licence: PA TP006200D) | |
Enumeration Date | 2006-10-27 |
Last Update Date | 2013-07-09 |