| NPI | 1700509841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY 383489) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 702047) |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2022-10-08 |