| NPI | 1992834386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QS1000X Clinic/Center Student Health (Licence: CA SS3066522) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 741) |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2007-07-08 |