| NPI | 1164773743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382366) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 22615826) |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2021-11-30 |