| NPI | 1487204871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383342) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 383342) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 201913485) | |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2023-07-22 |