NPI | 1417561861 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: WA AP61445072) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60519580) |
Enumeration Date | 2020-09-02 |
Last Update Date | 2024-05-29 |