| NPI | 1417331117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382617) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 671928) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2017-05-17 |