| NPI | 1619453552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MT NUR-APRN-LIC-176062) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60854096) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2024-02-19 |