| NPI | 1093891368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 381432) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F381432) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: VT 101.0128978) | |
| Enumeration Date | 2006-10-30 |
| Last Update Date | 2022-04-20 |