NPI | 1386913762 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R134751) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MD R134751) |
Enumeration Date | 2011-12-14 |
Last Update Date | 2011-12-15 |