NPI | 1295367886 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP61058265) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: WA RN60345209) |
Enumeration Date | 2020-02-11 |
Last Update Date | 2020-11-03 |