| NPI | 1922414747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024171805) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001225591) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-09-03 |