NPI | 1275389330 |
---|---|
Former Name | JOSEPHINE B NIEDERST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 354286) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 774632-01) |
Enumeration Date | 2024-04-29 |
Last Update Date | 2025-02-13 |