| NPI | 1124101555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60746642) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP003094B) |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2019-12-16 |