| NPI | 1043589716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP017152) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: DC 1024243) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 719890) | |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2017-03-13 |