NPI | 1396026084 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA TP004730D) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ00362300) |
Enumeration Date | 2011-09-08 |
Last Update Date | 2012-10-04 |