| NPI | 1700104866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP9595) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382117) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2020-07-17 |