| NPI | 1174064802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201700303NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60741544) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2022-05-03 |