| NPI | 1194120576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP014362) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN656227) |
| 163W00000X Registered Nurse (Licence: DE L1-0044884) | |
| 163W00000X Registered Nurse (Licence: NJ 26NR17243300) | |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-30 |