| NPI | 1104106640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: WA AP60246950) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60246950) |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2021-06-24 |