| NPI | 1316112972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0024165879) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024165879) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2020-01-31 |