| NPI | 1104467620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61045635) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK R0113839) |
| Enumeration Date | 2019-10-06 |
| Last Update Date | 2021-01-07 |