| NPI | 1316974736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: WA AP60326662) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: CO 79588) |
| 363L00000X Nurse Practitioner (Licence: WA AP60326662) | |
| 363LF0000X Nurse Practitioner Family (Licence: WA AP60326662) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2015-04-17 |