NPI | 1114917671 |
---|---|
Former Name | SANDRA JEAN DIXON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WH0200X Registered Nurse, Home Health (Licence: CA 235654) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CA 235654) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 3089) | |
Enumeration Date | 2005-10-26 |
Last Update Date | 2007-07-08 |