| NPI | 1063956225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383579) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 685907-1) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 14220) | |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2025-01-09 |