| NPI | 1558703462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 382393) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY F382393) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382393) | |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2016-11-04 |