| NPI | 1790146918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95017357) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2276801) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: DC RN1054076) | |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2021-08-02 |