| NPI | 1790066595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: PA SP007201) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9179586) |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2013-03-22 |