| NPI | 1982242129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY F383075-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 783809) |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2020-01-13 |