| NPI | 1114910122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 200550058NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP30007006) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IA H156296) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2020-01-28 |