| NPI | 1164195053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95017926) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017926) |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2022-05-26 |