| NPI | 1184105694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: WA 60895993) |
| Additional Taxonomies | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: WA 60768281) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-10-10 |