| NPI | 1043631278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 286382) |
| Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: NY 286382) |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2015-02-16 |