| NPI | 1154488336 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4188) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP3789) | 
| Enumeration Date | 2007-01-03 | 
| Last Update Date | 2016-03-10 |