| NPI | 1104316454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382872) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 137013) |
| 163W00000X Registered Nurse (Licence: NY 727527) | |
| Enumeration Date | 2018-05-12 |
| Last Update Date | 2022-01-18 |