| NPI | 1043612906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 18920) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60503181) |
| 363L00000X Nurse Practitioner (Licence: WA N360510248) | |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2018-03-05 |