| NPI | 1194109900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 20160695) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 686664-1) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2022-07-21 |