| NPI | 1174917926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382480-1) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 618865-1) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2015-03-19 |