| NPI | 1477873123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024168337) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0024168337) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2010-06-04 |