| NPI | 1760133607 |
|---|---|
| Former Name | EMILY ROSE DEMUTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383335) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 716540) |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-01-12 |