| NPI | 1356860084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 24175384) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 1248189) |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2017-12-20 |