| NPI | 1295717262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60727687) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704133157) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2020-07-15 |