| NPI | 1174105878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11010656) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11010656) |
| 163W00000X Registered Nurse (Licence: CA 796589) | |
| 163W00000X Registered Nurse (Licence: FL 3275812) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95010132) | |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2023-01-12 |