| NPI | 1609194737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP3039) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN139505) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2010-05-13 |