| NPI | 1659891042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382836) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 713794) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2018-04-11 |