NPI | 1457395121 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F380622) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NN08245200) |
Enumeration Date | 2006-06-15 |
Last Update Date | 2009-05-20 |