| NPI | 1053887976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F383352-01) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 24968) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 24968) | |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2022-09-07 |