NPI | 1104009208 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 17583) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CA 641288) |
Enumeration Date | 2007-12-11 |
Last Update Date | 2022-02-11 |