| NPI | 1164060489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95018347) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95201248) |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2022-01-09 |