| NPI | 1104875954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA RN 0067490) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP30005350) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2007-07-08 |