| NPI | 1265462162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP30005088) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP30005088) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2011-06-27 |