| NPI | 1700063781 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: DE L10040420APN000161)  | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA UP003039D)  | 
| Enumeration Date | 2008-01-22 | 
| Last Update Date | 2012-09-18 |