| NPI | 1790855369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA NP12049) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NV APN001094) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 200350099NP) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2016-04-01 |