| NPI | 1982760559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA NP7133) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA NP7133) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 357131) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2023-10-20 |