| NPI | 1124132733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 186597-4405) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ RN101975) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2013-02-05 |