| NPI | 1700956703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP1307) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: AZ RN14260) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2011-05-12 |