| NPI | 1508490160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN00155873) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP61057765) |
| Enumeration Date | 2020-02-22 |
| Last Update Date | 2020-07-02 |