| NPI | 1740664523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95028024) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 686617-1) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382613) | |
| Enumeration Date | 2015-07-12 |
| Last Update Date | 2024-03-16 |