| NPI | 1144745712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95007240) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95069832) |
| 163WP0200X Registered Nurse Pediatrics (Licence: CA 95069832) | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 95007240) | |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2022-07-21 |