| NPI | 1063045219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61037403) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NV 828677) |
| 363L00000X Nurse Practitioner (Licence: OR 202001616NP-PP) | |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-06-17 |