| NPI | 1982004792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 21393) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 740170) |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2015-06-18 |