| NPI | 1053340232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 69496) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30005933) |
| 207Q00000X Family Medicine (Licence: AK 869) | |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2014-12-09 |