NPI | 1114196425 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 16890) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 607923) |
Enumeration Date | 2008-02-21 |
Last Update Date | 2008-02-21 |