| NPI | 1487959318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP014673) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024169143) |
| 363L00000X Nurse Practitioner (Licence: PA SP014673) | |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2016-07-15 |