| NPI | 1942850144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP020918) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: PA RN648356) |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2019-10-04 |