| NPI | 1033751078 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP62936) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61002929) | 
| Enumeration Date | 2019-10-10 | 
| Last Update Date | 2024-04-15 |