| NPI | 1780854208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95005406) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2013028848) |
| 363L00000X Nurse Practitioner (Licence: MO 2013028848) | |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2017-01-20 |