NPI | 1962071225 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 383046) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 0686577) |
Enumeration Date | 2021-06-22 |
Last Update Date | 2021-06-22 |