| NPI | 1154500981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 003604) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60785852) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2020-01-09 |