| NPI | 1174749154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 4212561) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F 381370-1) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2007-08-02 |