| NPI | 1063822096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 23351) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 23351) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2022-09-08 |