NPI | 1023540978 |
---|---|
Former Name | LAURA CATHERINE TILLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60748250) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: WA 60740767) |
Enumeration Date | 2017-03-30 |
Last Update Date | 2017-03-30 |