| NPI | 1255672218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 22295) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 22295) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 22295) | |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2021-03-01 |