| NPI | 1225194855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: WA AP30003689) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: WA RN00099564) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2007-07-26 |