| NPI | 1619510872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95012836) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95194733) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2021-05-17 |