NPI | 1417234360 |
---|---|
Former Name | TERRI DENISE DAVIS-MENDOZA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 11720) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CA Lic#438822cert#11720) |
Enumeration Date | 2011-11-07 |
Last Update Date | 2022-02-23 |