| NPI | 1457566176 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA VP001426D)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN269878L)  | 
| Enumeration Date | 2007-05-14 | 
| Last Update Date | 2014-06-04 |