| NPI | 1700354743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 219814) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ RN183654) |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2018-12-04 |