| NPI | 1114267572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 10129) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382340) |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2024-06-07 |