| NPI | 1134792617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA 61208819) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA 61202048) |
| 163W00000X Registered Nurse (Licence: WA 61173482) | |
| 163W00000X Registered Nurse (Licence: CT 163876) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP61202048) | |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2021-08-13 |