| NPI | 1174811749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382156-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 580216-1) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2014-03-05 |