| NPI | 1871707703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60304097) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 0840599598N2) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2016-03-22 |