| NPI | 1811294614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024167941) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001191706) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2015-12-08 |