| NPI | 1013328459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP5560) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN170252) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2016-04-14 |