NPI | 1316256043 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F381362-1) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 358039-1) |
Enumeration Date | 2010-09-29 |
Last Update Date | 2020-01-30 |