NPI | 1083003230 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382462) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP014438) |
Enumeration Date | 2015-01-12 |
Last Update Date | 2021-11-17 |