| NPI | 1548510985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WY 52122) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60729893) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2025-02-05 |