| NPI | 1245533587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60689188) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 71704) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95000254) | |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2023-09-18 |