| NPI | 1720638794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP020607) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: PA SP020607) |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2019-09-12 |