| NPI | 1144880188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61076239) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 344535) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 344535) | |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2021-11-05 |