| NPI | 1346521929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382585) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2295111) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 4791) | |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2021-03-26 |