| NPI | 1912272030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: PA SP011908) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP011908) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP011908) | |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2020-10-07 |