NPI | 1093379869 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 9501532) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95172076) |
Enumeration Date | 2019-04-27 |
Last Update Date | 2020-11-12 |