NPI | 1104814284 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30004746) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA AP30004746) |
Enumeration Date | 2005-10-12 |
Last Update Date | 2024-10-22 |