| NPI | 1407971682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: VA 0024165392) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0024165392) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2024-01-29 |