NPI | 1720429699 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95000554) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: CA 828252) |
Enumeration Date | 2013-07-08 |
Last Update Date | 2014-09-15 |