| NPI | 1225493695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP017254) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R219689) |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2017-05-07 |