| NPI | 1033521133 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 290107)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.031591)  | 
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 290107)  | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN237918)  | |
| Enumeration Date | 2014-05-22 | 
| Last Update Date | 2025-04-15 |