| NPI | 1689298309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA 61206206) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA 61185124) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: MN 2458932) | |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2021-11-17 |