| NPI | 1104493865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61185290) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 202105283NP-PP) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2021-11-13 |