| NPI | 1407039340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383774) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 1194683) |
| 163W00000X Registered Nurse (Licence: NY 960780) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024167515) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY MM9459000) | |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2025-05-01 |