| NPI | 1972150019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP027023) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R187290) |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2023-02-02 |