| NPI | 1629388004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 382072) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 382072) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2014-10-21 |