| NPI | 1053690024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 20847) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 20847) |
| 163W00000X Registered Nurse (Licence: CA 498625) | |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2020-01-14 |