| NPI | 1063897965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: WA AP61040791) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OK 89219) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2021-05-27 |