| NPI | 1780059030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: CA 95003548) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 95003548) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: CT 12.008276) | |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2022-09-12 |