NPI | 1487116356 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP61429568) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-166683) |
Enumeration Date | 2019-04-01 |
Last Update Date | 2023-06-22 |