| NPI | 1083011878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 24172130) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 001714193) |
| Enumeration Date | 2014-11-23 |
| Last Update Date | 2018-07-05 |