NPI | 1366786295 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 22470) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 22470) |
Enumeration Date | 2012-11-15 |
Last Update Date | 2016-10-12 |