| NPI | 1275169690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 8505124-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA 60784832) |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2022-08-04 |