NPI | 1235564030 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ00463400) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP013172) |
Enumeration Date | 2013-09-11 |
Last Update Date | 2020-10-01 |