| NPI | 1306524012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61430133) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 63793) |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2023-07-20 |