| NPI | 1003302399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA RN627576) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA rn627576) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-08-21 |