| NPI | 1912691007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383592) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 773862) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2025-11-24 |