NPI | 1700593381 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F383424-01) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 804441-01) |
Enumeration Date | 2022-11-02 |
Last Update Date | 2022-11-02 |