| NPI | 1962761759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: VA 0024164306) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 20111212) |
| 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: VA 0001142388) | |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-05-14 |