| NPI | 1700403656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 251528) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN175060) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2021-06-24 |