NPI | 1740304948 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 124767) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 124767) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 000124767) | |
Enumeration Date | 2007-03-16 |
Last Update Date | 2009-03-24 |