| NPI | 1871877563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60355500) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 359149) |
| 363L00000X Nurse Practitioner (Licence: WA AP60355500) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH 12586-NP) | |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2014-11-12 |