| NPI | 1104993179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60194888) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: CA 352639) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2015-07-06 |