NPI | 1942547211 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382080-1) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 590020) |
Enumeration Date | 2013-01-07 |
Last Update Date | 2013-01-07 |