| NPI | 1215213384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 21404) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 786781) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 9353434) | |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2016-01-04 |