| NPI | 1225161763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP2628) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN119828) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2011-08-02 |