| NPI | 1811158397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024171260) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R154050) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2014-01-02 |