NPI | 1780059030 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA 95003548) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95003548) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 12.008276) | |
Enumeration Date | 2015-12-10 |
Last Update Date | 2022-09-12 |