| NPI | 1699220079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 9437093) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95001137) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2016-08-26 |