NPI | 1053797803 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382725) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MD R197734) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R197734) | |
Enumeration Date | 2015-08-04 |
Last Update Date | 2018-04-09 |