| NPI | 1063888410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 9461) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382554) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2021-08-03 |