NPI | 1629478706 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 53-76377-052) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2014022525) |
Enumeration Date | 2014-08-26 |
Last Update Date | 2014-08-26 |