| NPI | 1558358002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: PA RN531128) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR12209600) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP007665) | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2007-07-08 |