| NPI | 1912479551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP019827) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP019827) |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2023-07-06 |