| NPI | 1104584853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP61167392) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60636389) |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2022-09-14 |