| NPI | 1114646759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95022072) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 95022072) |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2023-02-21 |