NPI | 1790197853 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5007068) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F381546-1) |
Enumeration Date | 2014-05-23 |
Last Update Date | 2015-03-16 |