| NPI | 1043622533 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71004910A) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3009488) | 
| Enumeration Date | 2014-06-02 | 
| Last Update Date | 2025-03-19 |