| NPI | 1780056481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95033625) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71005881B) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2025-04-08 |