| NPI | 1164659595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP60565195) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60565195) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2018-03-17 |