| NPI | 1366459851 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP 2637) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA RN455955) | 
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ RN144099) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA NP9692) | |
| Enumeration Date | 2006-08-01 | 
| Last Update Date | 2008-06-06 |