| NPI | 1689665952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP059690) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NR09657400) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2007-08-14 |