NPI | 1639143266 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 109740) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 109740) |
Enumeration Date | 2006-02-13 |
Last Update Date | 2007-07-08 |