| NPI | 1962574012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA 004398) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP008766) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA RN534482) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA MK1336658) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2011-12-01 |