| NPI | 1003004573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60525658) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP2791032) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2015-07-07 |