| NPI | 1912096249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024178297) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 17778) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2022-08-08 |