NPI | 1407119175 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA UP006598B) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA UP006598B) |
Enumeration Date | 2012-06-19 |
Last Update Date | 2012-12-03 |