| NPI | 1952840308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP017063) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN646158) |
| 163W00000X Registered Nurse (Licence: DE L1-0047415) | |
| 163W00000X Registered Nurse (Licence: NJ 26NR18258500) | |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2017-02-17 |