| NPI | 1164761680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 22496) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 818583) |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2016-02-29 |