| NPI | 1619328929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024176790) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001281264) |
| 163W00000X Registered Nurse (Licence: MA RN2302044) | |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2018-10-25 |