NPI | 1306484555 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95015616) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 152960) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95015616) | |
163W00000X Registered Nurse (Licence: CA 95190203) | |
Enumeration Date | 2019-12-18 |
Last Update Date | 2024-09-06 |