| NPI | 1194919647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: ID NP-825A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP30007996) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2016-03-08 |