NPI | 1124544192 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ID 70203) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60583927) |
Enumeration Date | 2017-08-21 |
Last Update Date | 2024-07-08 |