| NPI | 1962810788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F383277-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 683185-1) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2022-01-14 |