NPI | 1982699658 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA C048985) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA 19990513) |
Enumeration Date | 2005-09-19 |
Last Update Date | 2010-10-15 |