| NPI | 1891966743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 381949) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 3181949) |
| 163W00000X Registered Nurse (Licence: NY 576025-1) | |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2017-03-29 |