| NPI | 1902896632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP008107) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN543487) |
| 163W00000X Registered Nurse (Licence: NJ 26NR11548300) | |
| 163WL0100X Registered Nurse, Lactation Consultant (Licence: PA L-56479) | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2014-11-17 |