NPI | 1417222027 |
---|---|
Former Name | JAMI MARIE VANDERWIELEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 21469) |
Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA NP21469) |
Enumeration Date | 2012-03-14 |
Last Update Date | 2020-05-11 |