| NPI | 1316981665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60139272) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH RN.310987-COA1) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 733750) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA RN60126218) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-03-22 |