| NPI | 1013258268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP61093753) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ID NP-1256A) |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2023-02-13 |