| NPI | 1861823122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: AZ 254993) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN106996) |
| 163WP0200X Registered Nurse Pediatrics (Licence: AZ RN106996) | |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2021-04-09 |