| NPI | 1639482011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP011069) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: PA RN557048) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: NJ 26NR14587700) | |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2010-11-15 |