NPI | 1992042667 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383127) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 650802) |
Enumeration Date | 2013-01-14 |
Last Update Date | 2020-08-03 |