| NPI | 1265990212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: DC NP1049347) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024177244) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: VA 0024177244) | |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2024-08-27 |