| NPI | 1043997885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: WA AP61427518) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61427518) |
| 363LF0000X Nurse Practitioner Family (Licence: WA AP61427518) | |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2023-07-27 |