| NPI | 1780884205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 381940) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 520046-1) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2019-10-10 |