| NPI | 1902238553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60553295) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NE 111558) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2018-11-19 |