NPI | 1093087439 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382260) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 961698) |
Enumeration Date | 2012-02-01 |
Last Update Date | 2014-08-21 |