NPI | 1073931853 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F3893095) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 650798) |
Enumeration Date | 2014-03-31 |
Last Update Date | 2020-07-28 |