NPI | 1831475698 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383264) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 636479-1) |
Enumeration Date | 2011-10-25 |
Last Update Date | 2021-11-17 |