| NPI | 1992158687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP8802) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: AZ AP8802) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2021-06-29 |