| NPI | 1275211336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 76466) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61456030) |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-07-10 |