| NPI | 1114200094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: WA AP60655666) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60655666) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2020-07-01 |