NPI | 1093157166 |
---|---|
Former Name | ALEXANDRIA PATRICE SHIRLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382443) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 657910) |
Enumeration Date | 2013-07-18 |
Last Update Date | 2020-12-30 |