| NPI | 1871645358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA NP20617) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP3994) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2011-05-01 |