| NPI | 1477573459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP30001891) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 2132-033) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2008-08-11 |