| NPI | 1043680978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95004255) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: CA 95004255) |
| 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: PA SP015426) | |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2019-03-05 |