| NPI | 1811075070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA RN532602) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA RN532602) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP008417) | |
| 363L00000X Nurse Practitioner (Licence: PA SP008417) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2011-08-30 |