| NPI | 1821292954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP011636) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN287003L) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2015-09-07 |