| NPI | 1770786436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 353578-1) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F380238-1) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2007-07-09 |