| NPI | 1174954978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LS0200X Nurse Practitioner School (Licence: CA 276628) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 276628) |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2013-12-03 |