| NPI | 1245791136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 20213486NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WA AP60942007) |
| 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: WA AP60942007) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2022-03-01 |