NPI | 1164049904 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 95023995) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95097816) |
Enumeration Date | 2020-06-27 |
Last Update Date | 2024-03-02 |