| NPI | 1760233738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R264318) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R264318) |
| 163W00000X Registered Nurse (Licence: NY 741136) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383605) | |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-03-28 |