| NPI | 1811303191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95002627) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95062551) |
| 163W00000X Registered Nurse (Licence: NY 2267193) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2019-05-20 |