| NPI | 1225388028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 24686A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA 60310022) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2014-10-30 |