| NPI | 1114234408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F381252-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 401862-1) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2010-09-08 |