| NPI | 1982311874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: VA 0024185800) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001299152) |
| 163W00000X Registered Nurse (Licence: DC 1048949) | |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2022-11-17 |