| NPI | 1982324026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F383507) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 841192-01) |
| 163W00000X Registered Nurse (Licence: MA RN2348486) | |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2023-01-09 |