| NPI | 1205919636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F380702) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 406983) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY F380702) | |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2021-01-13 |