| NPI | 1083782627 |
|---|---|
| Former Name | SANDRA MARY BURMYLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NN09422800) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NN09422800) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-10-18 |