| NPI | 1629400999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 95015527) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: IN 28182117A) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: IN 71004555A) | |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2020-10-16 |