| NPI | 1174060313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382684) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 646842) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-26 |