| NPI | 1912158429 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: DE L1-0040338) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP008698) | 
| Enumeration Date | 2008-10-02 | 
| Last Update Date | 2020-04-21 |