| NPI | 1235771304 |
|---|---|
| Former Name | CARRIE DONOVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95026486) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CA 911760) |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2023-08-11 |