| NPI | 1164195459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA 61209842) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: WA RN6097853) |
| Enumeration Date | 2021-08-01 |
| Last Update Date | 2021-11-12 |