| NPI | 1689066961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 95001622) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 802021) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2015-02-24 |