| 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 |