| NPI | 1578086369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382752) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 382752) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382752-1) | |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2023-09-01 |