| 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 |