NPI | 1053794172 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382625-1) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 683155) |
Enumeration Date | 2015-07-07 |
Last Update Date | 2017-05-04 |