| NPI | 1396876520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0001170024) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: VA 0024165936) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2012-07-18 |