| NPI | 1770782310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: VA 0024185387) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: NC 160018) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2023-08-10 |