| NPI | 1649546052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 209.018506) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 635555) |
| 163WH0200X Registered Nurse, Home Health (Licence: NY 635555) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382274) | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2021-08-12 |