| NPI | 1417929704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024078793) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001-078793) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2008-05-12 |