| NPI | 1790768240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 11719) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: CT 002184) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2023-04-24 |