| NPI | 1477062230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP018211) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN00000) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2017-12-04 |