| NPI | 1710280409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 14788) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 109947) |
| Enumeration Date | 2010-12-18 |
| Last Update Date | 2022-08-19 |