| NPI | 1114155173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP 60182018) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201050174NP) |
| 363LS0200X Nurse Practitioner, School (Licence: WA RN00110068) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2013-05-23 |