| NPI | 1073862884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 7848035) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 382291) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2023-07-07 |