| NPI | 1821470162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 5361) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22 662311) |
| 163W00000X Registered Nurse (Licence: MN 197806) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382621-1) | |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2018-09-20 |