| NPI | 1093353450 |
|---|---|
| Former Name | ALEXANDRA PECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 348566) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024178487) |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2023-05-04 |