| NPI | 1982663456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F380308-1) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 369422-1) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2021-03-20 |