| NPI | 1669107900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95022405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95251430) |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2022-08-31 |