| NPI | 1336621986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60986221) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: ID 58911) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: ID 58911) | |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2019-12-11 |