| NPI | 1467870949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024173168) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001262139) |
| 163W00000X Registered Nurse (Licence: MA RN2291761) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2291761) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2018-10-18 |