| NPI | 1578545067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ RN071704) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP7011) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2016-10-21 |