| NPI | 1376094144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95005078) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95107314) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |