NPI | 1194968693 |
---|---|
Former Name | CARON C PEDERSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7572) |
Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: AZ 5882) |
Enumeration Date | 2009-04-13 |
Last Update Date | 2016-11-30 |