| NPI | 1982212163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95012509) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95190355) |
| 163W00000X Registered Nurse (Licence: NY 740019) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F383013) | |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-07-14 |