| NPI | 1225502917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95010031) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95175121) |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2019-01-15 |