NPI | 1558703918 |
---|---|
Former Name | NICHOLE ANNE CASTILLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 2253) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MN 2067805) |
Enumeration Date | 2013-07-25 |
Last Update Date | 2023-10-06 |