| NPI | 1124002563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA 025804 AP30000064) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP30000064) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2018-08-30 |