| NPI | 1912546813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP021321) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN687157) |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2019-12-26 |