| NPI | 1346780368 |
|---|---|
| Former Name | NADEZHDA TSERADZE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342620-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 579918-1) |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2018-05-01 |