| NPI | 1215257696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 16038) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CA 234624) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2010-06-08 |