| NPI | 1962928150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95007747) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 129110) |
| 163W00000X Registered Nurse (Licence: CA 95133798) | |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2023-02-08 |