| NPI | 1598011421 |
|---|---|
| Former Name | MARJORIE PEGUERO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 383039) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 659587) |
| 363L00000X Nurse Practitioner (Licence: NY 383039) | |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2023-03-15 |