| NPI | 1740631753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95004418) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 95004418) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2018-01-02 |