| NPI | 1164104204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F383567-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 827547-01) |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2023-08-07 |