| 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 |