| NPI | 1407039340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024167515) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ RN148478) |
| 208000000X Pediatrics (Licence: VA 0001194683) | |
| 363L00000X Nurse Practitioner (Licence: VA 0017139351) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA GM5112329) | |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2020-11-09 |