| NPI | 1144261124 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R111998) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R111998) | 
| Enumeration Date | 2006-06-09 | 
| Last Update Date | 2018-03-17 |