| 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 |