| NPI | 1861130130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 95034583) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX 1075010) |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2025-07-24 |