NPI | 1720553613 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60854654) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WA AP60854654) |
Enumeration Date | 2018-10-08 |
Last Update Date | 2018-11-26 |