NPI | 1144750761 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382950) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 717938) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: OH 022743) | |
Enumeration Date | 2017-06-15 |
Last Update Date | 2023-09-19 |