| NPI | 1184396194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA 61192030) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 61192030) |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2022-01-14 |