NPI | 1801063797 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 268060) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 9179151) |
Enumeration Date | 2008-05-10 |
Last Update Date | 2019-06-25 |