| NPI | 1164463444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F381489-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F018591) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2018-04-12 |