NPI | 1740535327 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 335850) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 594054) |
Enumeration Date | 2012-07-19 |
Last Update Date | 2018-04-03 |