| NPI | 1154353118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60844713) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID NP496A) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-04-05 |