| NPI | 1275807208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP013825) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA 514032L) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 551174) | |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2020-08-26 |