NPI | 1790065811 |
---|---|
Former Name | TEENA KAREN DEIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA VP003464D) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN176600L) |
Enumeration Date | 2011-08-20 |
Last Update Date | 2011-08-20 |