| NPI | 1740286608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 5323055) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F380804-1) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2007-07-08 |