| NPI | 1760164628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383785) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95026390) |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2025-02-10 |