| 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 |