| NPI | 1861640930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP3101) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 201250031NP) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2021-12-03 |