| NPI | 1063948453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95006432) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 95006432) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2024-07-31 |