| NPI | 1508097247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382111-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 601494-1) |
| 163W00000X Registered Nurse (Licence: VT 026.0042618) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: ND R43064) | |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2016-04-28 |