| NPI | 1104102805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: AZ AP4322) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: WA AP60172243) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2016-01-07 |