| NPI | 1851463236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F381296) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NN05927600) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-08 |