| NPI | 1336511575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA 6091135) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN219260) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA 219260) | |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2018-12-26 |