NPI | 1487924643 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95000938) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN264689) |
Enumeration Date | 2012-01-05 |
Last Update Date | 2018-12-13 |