| NPI | 1255579843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 18487) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 18487) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2015-08-06 |