| NPI | 1639601446 |
|---|---|
| Former Name | JENNIFER SHIELDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: CA 95004698) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2017-03-30 |