| NPI | 1962573063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA NP11636) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA NP11636) |
| 163W00000X Registered Nurse (Licence: CA RN508617) | |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2016-09-01 |