| NPI | 1871840165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11015767) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9579686) |
| 163WG0000X Registered Nurse, General Practice (Licence: NY 609629) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382206) | |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2022-05-02 |