| NPI | 1770851636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA NP95000402) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN282081) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2015-09-10 |