| NPI | 1396460390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024191764) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001294625) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 1396460390) | |
| Enumeration Date | 2022-10-11 |
| Last Update Date | 2025-08-07 |