NPI | 1871933879 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95000707) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22 657951) |
163WP0200X Registered Nurse, Pediatrics (Licence: CA 850110) | |
Enumeration Date | 2013-07-05 |
Last Update Date | 2020-03-24 |