| NPI | 1790891646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA VP004240D) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN179185L) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2011-05-16 |