| NPI | 1356862247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LJ-0000340) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 667138-1) |
| 363L00000X Nurse Practitioner (Licence: PA SP018760) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2019-01-28 |