NPI | 1588213532 |
---|---|
Former Name | CANDACE-RAE DIANA HAISLIP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0222X Nurse Practitioner Pediatrics, Critical Care (Licence: MO 2013035101) |
Enumeration Date | 2019-09-11 |
Last Update Date | 2023-12-11 |