| NPI | 1972171015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383233) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 383233) |
| 163W00000X Registered Nurse (Licence: NY 698967) | |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2026-04-29 |