| NPI | 1164450375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP30005734) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID N-29564) |
| 363L00000X Nurse Practitioner (Licence: ID NP487A) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2015-12-09 |