| NPI | 1003021080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5004154) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ RN048722) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP1290) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2022-12-20 |