| NPI | 1730681602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0200X Registered Nurse, Pediatrics (Licence: CA 714581) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 95007987) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95007987) | |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2020-08-05 |