| NPI | 1659890101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60941533) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95006119) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2019-05-09 |