| NPI | 1245312628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F380731-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 436378-1) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2009-01-08 |