NPI | 1417567991 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383134) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 758065) |
Enumeration Date | 2020-08-09 |
Last Update Date | 2023-09-14 |