NPI | 1710512710 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ01212900) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: PA 26NR17493700) |
Enumeration Date | 2020-03-10 |
Last Update Date | 2021-10-22 |