| NPI | 1700062866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP013398) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WV 47713) |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2014-12-29 |