| NPI | 1588194930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382831) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 717644) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2018-07-23 |