| NPI | 1487177432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 382953) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MA RN2310326) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: CT 7582) | |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2019-04-14 |