| NPI | 1073097630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95010207) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95171328) |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2018-10-15 |