| NPI | 1083092977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383018) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 701502) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2020-02-04 |