| NPI | 1790035046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 19921) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: CA 19921) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2020-03-30 |