| NPI | 1710559158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: VA 0024183880) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MD R248622) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2023-12-29 |