| NPI | 1104134089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1060A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60314925) |
| 363LF0000X Nurse Practitioner, Family (Licence: ID NP22045) | |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2023-10-04 |