| NPI | 1912614033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383480) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 858263) |
| Enumeration Date | 2022-10-28 |
| Last Update Date | 2022-10-28 |