| NPI | 1073135661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP61099151) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: WA 00173684) |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2020-10-02 |