| NPI | 1104142074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY f382125) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: NY f382125) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2021-08-06 |