NPI | 1508252040 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 566824-1) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NR15406000) |
Enumeration Date | 2015-04-10 |
Last Update Date | 2015-04-10 |