| NPI | 1104268234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382435) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 658342) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2014-05-23 |