| NPI | 1194277699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95004799) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 9248655) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2016-10-31 |