| NPI | 1760525505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 38 382169) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 22 539932) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2021-03-30 |