| NPI | 1063939486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60852920) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R197548) |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2018-06-14 |