| NPI | 1235499930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: WA AP60448863) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: FL ARNP9219864) |
| 363L00000X Nurse Practitioner (Licence: WA AP60448863) | |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2014-06-18 |