| NPI | 1619318458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382432) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 658193-1) |
| 163W00000X Registered Nurse (Licence: NJ 26NR16603700) | |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2014-12-08 |