| NPI | 1942405840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F-381365-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 286334-1) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F-381365-1) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2024-02-23 |