| NPI | 1639226939 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0017136969) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0017136969) | 
| Enumeration Date | 2007-01-05 | 
| Last Update Date | 2025-07-27 |