NPI | 1902263809 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383139) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 700911) |
Enumeration Date | 2016-01-22 |
Last Update Date | 2020-07-22 |