NPI | 1003061722 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60854090) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 3731) |
Enumeration Date | 2008-11-21 |
Last Update Date | 2020-12-03 |