| 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 |