NPI | 1164761680 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 22496) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 818583) |
Enumeration Date | 2013-02-04 |
Last Update Date | 2016-02-29 |