| NPI | 1750650198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP012880) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP012880) |
| 363L00000X Nurse Practitioner (Licence: PA 018033) | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: NJ NJ00356100) | |
| 163W00000X Registered Nurse (Licence: PA RN556384) | |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2021-07-23 |