| NPI | 1487616413 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: NH 024689-23-02) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 024689-23-02) | 
| Enumeration Date | 2006-04-05 | 
| Last Update Date | 2011-11-10 |