NPI | 1639596950 |
---|---|
Former Name | ASHLEY ELIZABETH DODD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95001793) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CA 95047520) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: TN apn18656) | |
Enumeration Date | 2014-03-25 |
Last Update Date | 2015-06-23 |