NPI | 1760680813 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 16744) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 600443) |
Enumeration Date | 2007-07-10 |
Last Update Date | 2007-07-10 |