| NPI | 1619058567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F380484) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 380484) |
| 163W00000X Registered Nurse (Licence: NY 305207) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2021-01-20 |