| NPI | 1982024972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LJ-0000342) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN594486) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP013634) | |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2018-10-22 |