| NPI | 1215439989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60938220) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78040-041) |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2021-06-08 |