| NPI | 1386687374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382088) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA sp007475) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2010-01-15 |