| NPI | 1639455876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP014638) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ00350900) |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2016-01-05 |