NPI | 1982930236 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: DC rn1026938) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 278242) |
Enumeration Date | 2009-10-21 |
Last Update Date | 2012-12-05 |