| NPI | 1053369868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 13989) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: VA 0017139582) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: VA 0024168378) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-12-29 |