| NPI | 1275729832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP2858) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 064991-23) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2013-05-16 |