| NPI | 1265776900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024170525) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001241321) |
| 363L00000X Nurse Practitioner (Licence: VA 0024170525) | |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2023-12-29 |