| NPI | 1417671165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 383447) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 383447) |
| 363L00000X Nurse Practitioner (Licence: NY 383447) | |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2024-11-07 |