| NPI | 1942721360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382821) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 717780-1) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382821) | |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2019-01-08 |