| NPI | 1316218779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP30004111) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 082011115N3) |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2016-01-06 |