| NPI | 1649780784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95009033) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA 60795012) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2023-03-01 |