| NPI | 1134779457 |
|---|---|
| Former Name | GERALDINE MAE WATERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA 61193622) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2024-10-17 |