| NPI | 1932201795 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP3772) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 20030451) | 
| Enumeration Date | 2006-09-02 | 
| Last Update Date | 2021-07-12 |