| NPI | 1700061470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382505) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 16823) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 990023) | |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2020-03-06 |