| NPI | 1134620073 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP11076)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN137940)  | 
| Enumeration Date | 2018-02-26 | 
| Last Update Date | 2018-03-29 |