NPI | 1124513718 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60863673) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: WA RN00158970) |
Enumeration Date | 2018-06-26 |
Last Update Date | 2018-06-26 |