| 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 | 2024-11-05 |