| NPI | 1942730395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382824) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 71764-1) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2018-04-11 |