NPI | 1164708186 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383303) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 619939-1) |
Enumeration Date | 2011-10-24 |
Last Update Date | 2022-06-10 |