NPI | 1740409143 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN270714) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F381877-1) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2015-10-28 |