| NPI | 1124022165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 2295) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 2295) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2020-01-29 |