NPI | 1255837407 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382794) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 631114) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F3822794-1) | |
Enumeration Date | 2018-04-04 |
Last Update Date | 2022-07-14 |