NPI | 1144612763 |
---|---|
Former Name | RUCHOMA AVIGAIL KAGANOFF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 682398) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ15036700) |
Enumeration Date | 2015-02-19 |
Last Update Date | 2024-03-23 |