| NPI | 1962885202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: DC RN1044497) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 687196) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382605) | |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2018-03-17 |