| NPI | 1902279417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 340029) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 340029) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F340029) | |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2022-01-31 |