| NPI | 1205266749 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP5268) | 
| Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: AZ AP5268) | 
| Enumeration Date | 2013-11-20 | 
| Last Update Date | 2019-10-09 |