NPI | 1336293455 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP0200X Registered Nurse, Pediatrics (Licence: CA 465768) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 10450) |
Enumeration Date | 2007-01-23 |
Last Update Date | 2007-07-08 |