| NPI | 1255317806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 15110) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist Pediatrics (Licence: CA 2133) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2007-07-08 |