| NPI | 1639309768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA RN428111NP) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA RN428111) |
| 208000000X Pediatrics (Licence: CA RN42811) | |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2020-07-22 |