| NPI | 1538253158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 380743) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY f380743) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2011-11-29 |