| NPI | 1124291083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 381840) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 456583-1) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2020-04-27 |