NPI | 1255645701 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60175330) |
Additional Taxonomies | 261QC1500X Clinic/Center Community Health (Licence: WA AP60175330) |
Enumeration Date | 2010-07-27 |
Last Update Date | 2012-01-05 |