| NPI | 1962074039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: WA AP61514941) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: PA SP023255) |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2024-07-22 |