| NPI | 1578709119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 381993) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY F381993) |
| Enumeration Date | 2009-01-04 |
| Last Update Date | 2013-12-12 |