| NPI | 1366095689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 383518) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 866303) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2023-06-20 |