| NPI | 1306466180 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95014920)  | 
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CA 95106718)  | 
| Enumeration Date | 2020-04-21 | 
| Last Update Date | 2020-07-14 |