| NPI | 1104474519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60739309) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: WA AP60739309) |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2019-09-20 |