| NPI | 1871933879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 95000707) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22 657951) |
| 163WP0200X Registered Nurse Pediatrics (Licence: CA 850110) | |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2020-03-24 |