| NPI | 1164598280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA PA14471) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA14471) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2014-12-03 |