| NPI | 1265455372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60834499) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 1189) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC APNF1189) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201801215NP-PP) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-11-15 |