| NPI | 1124058490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61005965) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT RN - 31239) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2021-03-29 |