| NPI | 1124561790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM CNP-02967) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95002433) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2017-02-03 |