NPI | 1639255078 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC APN780) |
Additional Taxonomies | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: SC APN780) |
Enumeration Date | 2006-10-28 |
Last Update Date | 2007-07-08 |