NPI | 1811416886 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ00766300) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382772-1) |
208000000X Pediatrics (Licence: NJ 26NJ00766300) | |
Enumeration Date | 2017-09-11 |
Last Update Date | 2024-11-22 |