NPI | 1316493364 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382680) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 626486) |
Enumeration Date | 2016-08-30 |
Last Update Date | 2022-03-28 |