| NPI | 1710058664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0200X Registered Nurse, Pediatrics (Licence: VA 0001044806) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024044806) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |