| NPI | 1366650061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA UP006356D) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN266462L) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-02-05 |