| NPI | 1730368960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 15497) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 647986) |
| 363L00000X Nurse Practitioner (Licence: MI 4704287358) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704287358) | |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2022-07-21 |