| NPI | 1154086429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: ID 68988) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP61197755) |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2023-03-02 |