| NPI | 1376066225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95009784) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382848-1) |
| 163W00000X Registered Nurse (Licence: NY 717314-1) | |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2018-10-30 |