| NPI | 1659874907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 16609-33) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP61372601) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2025-05-29 |