| NPI | 1205811536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 258164) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: CA 258164) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2011-12-15 |