| NPI | 1467610840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA 007239) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ00152500) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2008-06-02 |