| NPI | 1205060415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024169514) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN APN13239) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2024-05-23 |