| NPI | 1831271485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: WA AP60228488) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN 307054) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: OH NP-08943) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2012-10-09 |