| NPI | 1154869071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11021270) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE L1-0046109) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ00714700) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: DE LJ-0000322) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP017149) | |
| Enumeration Date | 2017-02-11 |
| Last Update Date | 2022-12-09 |