| NPI | 1780116566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP017378) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN674320) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2017-03-30 |