| NPI | 1063801694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 56759) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60534587) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2023-11-07 |