| NPI | 1346645595 |
|---|---|
| Former Name | KAITLIN ELIZABETH REISS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95012201) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 225342) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 21374) | |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2021-03-18 |