| NPI | 1134505522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: SC 26705) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 26705) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382562) | |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2025-07-22 |