NPI | 1003261272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 357077) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 357077) |
Enumeration Date | 2016-04-25 |
Last Update Date | 2016-04-25 |