| NPI | 1053840546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 9928) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 10.129329) |
| 163W00000X Registered Nurse (Licence: NY 71152) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382784) | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-11-22 |