NPI | 1457078560 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95022521) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95141588) |
Enumeration Date | 2022-10-20 |
Last Update Date | 2024-10-02 |