NPI | 1588625107 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA 121268) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R 089542-2) |
Enumeration Date | 2006-03-31 |
Last Update Date | 2009-07-16 |