| NPI | 1144658493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 383197) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 672155) |
| 208000000X Pediatrics (Licence: NY 383197) | |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2021-11-04 |