| NPI | 1962743104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024170713) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: VA 0001192512) |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2013-08-08 |