| NPI | 1659608354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 23208) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 842645) |
| 163WP0200X Registered Nurse Pediatrics (Licence: PA RN581432) | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP010503) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: CA 23208) | |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2014-08-04 |