| NPI | 1649456674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 3562) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 4520) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2012-12-18 |