| NPI | 1952732869 |
|---|---|
| Former Name | BRONWYN BACKSTROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP08498) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: NY 382418) |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2018-11-05 |