| NPI | 1578636759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner Pediatrics, Critical Care (Licence: AZ AP4233) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP006403D) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2013-01-11 |