NPI | 1457649279 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 382225) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 591740) |
Enumeration Date | 2011-07-13 |
Last Update Date | 2011-07-13 |