NPI | 1972557395 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO APN.0992013-NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-263897) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209-005902) | |
Enumeration Date | 2006-05-20 |
Last Update Date | 2016-02-04 |