| NPI | 1770895260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 5582) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382143-1) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2014-09-23 |