| NPI | 1104923523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE LJ0000239) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R133498) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-03-17 |