| NPI | 1053043034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95021790) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2347915) |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2022-08-21 |