| NPI | 1831475698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383264) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 636479-1) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2021-11-17 |