| NPI | 1306484555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95015616) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 152960) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95015616) | |
| 163W00000X Registered Nurse (Licence: CA 95190203) | |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2024-09-06 |