| NPI | 1154310654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA VP003300D) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: PA RN171386L) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2009-03-01 |