| NPI | 1023667409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9631-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60455694) |
| Enumeration Date | 2019-09-08 |
| Last Update Date | 2019-09-24 |