| NPI | 1700478450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP023276) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R246255) |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2021-02-23 |