NPI | 1295143246 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382595-1) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 620622) |
Enumeration Date | 2014-07-22 |
Last Update Date | 2019-07-18 |