NPI | 1013390376 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382603-1) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 671916-1) |
Enumeration Date | 2015-07-06 |
Last Update Date | 2016-05-24 |