NPI | 1477551182 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MO 117512) |
Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: KS 45408) |
Enumeration Date | 2005-07-07 |
Last Update Date | 2017-01-05 |