| 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 |