| NPI | 1285976803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60940497) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 64630) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4894) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60940497) | |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2021-05-19 |