| NPI | 1104812718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 368209) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NJ 26NR06786500) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F380906) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NN06786500) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2007-07-08 |