NPI | 1689066961 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95001622) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 802021) |
Enumeration Date | 2015-02-24 |
Last Update Date | 2015-02-24 |