| NPI | 1801356068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP019485) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN609828) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2019-03-23 |