| NPI | 1104134923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP30002318) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00090270) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2010-09-14 |