| NPI | 1588909162 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AR A003793) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AR A003793) | 
| Enumeration Date | 2012-12-07 | 
| Last Update Date | 2020-12-07 |