NPI | 1114564937 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F383019-01) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY F383019-01) |
Enumeration Date | 2019-12-01 |
Last Update Date | 2024-03-15 |